Overcharging clients and under-paying
Posted By: Nmt on 2005-08-20
In Reply to: Question on MQ lawsuit. I do not want this to be a - NO FLAMES, please
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I think when clients were paying
what they considered to be 'top dollar' they felt they had every right to be picky about sentence structure, and the placement of every comma and semicolon, etc. Now that they want to pay 'scratch & dent' prices for their reports, they have to be willing to let some of their former pickiness slide. Not to say that they should accept reports riddled with errors, but some of the stylistic items that have no bearing on patient care can be overlooked - to save a buck.
I beg to differ. That is what the companies want you to believe. Not all clients are paying Less!
The companies are lining their pockets more and more. AccuStat-Carolinas is not a "good" company to work for anyway. Read the archives!
What are you paying your MTs? If you're only paying 7 or 8 cpl
and expecting extremely experienced MTs, forget it. You're not going to get it. If, however, you're willing to pay 9 or more cpl then you will find what you're looking for. There ARE experienced MTs out there who will work their fingers to the bone IF they are compensated well and treated with respect.
ATT- I was paying $320 for 7000 minutes, I am now paying $175 for 5000 minutes in CA. nm
nm
To get own clients or not....
I have thought about getting my own clients, but working for a company, if I want time off, I can easily arrange that and know there will be co-workers to cover the accts. If I get sick, the company will find someone to cover the accts. I don't have to worry about the billing, tech support, trouble-shooting, complaints. Maybe someday I will chose to give up what life I have and get my own clients, but for now I like being an IC for a company. This way, I am a great employee and an even better boss.
My clients...
Consist of clinics. They all get 48-hour turnaround time guaranteed, and anything STAT (a TRUE emergent STAT) they need, it's done at no extra charge. Radiology gets four to eight-hour turnaround for obvious reasons. The rest of the clinics don't need a 24-hour turnaround time because let's face it, their staff basically sit on it, and I'm not going to break my neck so they can just sit on it....
Clients
Hello! I'm new to the board but not to MT. I've been working from home for my own clients for 10 years. I wondered if others who do the same have ever experienced a situation I just encountered and wondered what your thoughts were. I had a client whom I transcribed for for two years, then he moved and started back up in his practice and called me and I've worked for him for an additional year in that new practice. When I noticed recently that I hadn't received his dictation as usual, I questioned it, i.e. was he on vacation, did they lose a tape or what? The receptionist said he must not have dictated yet. I found this off as he usually dictates each day he's in the office. A week had gone by w/o work so I called and asked and the same girl said she'd have his wife (who works in the office) call me because she didn't know why there wasn't work, etc. At this point I got suspicious and had asked the recep. if there was something going on I should know about. She said they're working on this new software and maybe they just got behind. New software? I talked to his wife and "I" mentioned this software. She didn't. I asked if this affected my workload and she said 'yeah, probably quite a bit.' I asked if she would please let me know AHEAD of time if they were going to make this transition so I could prepare and plan (she had just made it sound like they were just looking into it and kind of testing it out, NOT that they'd by any means started using it full-time). She said oh certainly they would let me know ahead of time. Then I pressed a little more and finally she told me he'd already been using it for his patients and when I asked if I should replace his work, she said yeah, probably because he really seems to like it and will probably use it. I don't know what the software is but I hate it just because it took a big client from me. But I"m also wondering if this is common practice for a physician just to outright not tell an MT that they weren't going to use their services any more. I mean, not only did they not give me notice beforehand, but they hedged on admitting it when I came right out and asked. I find this incredibly rude and inconsiderate, especially when I've been a faithful MT for them for three years. I"m just dumbfounded at this behavior. Has anyone experienced this? So now that leaves me in the lurch with bills to pay with an already tight budget (hubby in college, two kids, high heat bills, blah, blah, etc.) and me looking for work to fill in the gap. Sorry I ranted and rambled. I'm just really upset by this and wondered if anybody experienced being treated this way and/or knows what this software might be and if it poses a threat to any of us. Thanks so much!
Own clients
This has been discussed many times with many different opinions/ideas. You might do a search as there was quite a heated debate on this about two months ago. I have a brochure that I send out with my card. For those I am very interested in I do stop by in person or if anyone calls inquiring I stop by in person. You have to be prepared with equipment to do tapes or digital and some may inquire about a call in system. You may have to pick up and deliver, provide your own paper. Be prepared to do any type accounts. Your rate will depend on the area you are in and can be anywhere from 11 to 16 cpl from what people say on this board. You have to be prepared to have some back up if you get very sick or have an accident and for vacations. You will not get any benefits, will not getpaid when the doctor takes a month off to go to Spain. It will be a tough go at first until you esablish a rapport with the office staff. But I like it and have been doing it for 18 years. Just did a report and have made 4K more this year than I did last year so things are looking up for me. Good luck. Patti
One of my clients for whom I have done only
tapes for has given me a CD to load onto my computer. I haven't put it on yet but I'm wondering if you all can help. It's an Olympus CD and looks like it's for .wav files which is what he intends. He says I should be able to load this onto my computer and then after that, he can email me voice files. Now, is this correct and what will I need to have in order to play and transcribe his voice files? I have a Bytescribe pedal. Please tell me I won't have to buy a different pedal for this! Thanks in advance for any help!
want to get own clients
Hi Everyone,
I have over 2 years’ experience in medical transcription and really want to get my own client(s). I feel that I am finally ready to take that leap. The question I have is – how do you go about talking to potential clients? What is the best way? Mailings, calling, just going in? Should I make business cards? Unfortunately all of my doctors offices (family, ob/gyn) husband's GI doc and daughter's pediatrician are all EMR. Ugh. So that's no help.
I’m not really afraid of what to charge or contracts, the rest is what has me stressed the most. Should I buy a program like DocShuttle or will they basically tell me what they want? I have been with nationals and small MTSOs alike and just am not sure how to go about everything myself.
You can feel free to e-mail me with any advice also.
I really appreciate the suggestions/help!!!
Getting own clients
I am currently transcribing for GI docs who are using the EMR system, I love it. There is barely any paper for me to handle, I fax everything right from their system to the referring physicians, once in a while I will get a physician who doesn't have a fax and so I need to mail. The final copy goes right into their system. I am currently working from home through my business. They had the equipment installed at my house, fortunately for me, I was with them for four years before I went on maternity leave and have been doing it from home for the past two years.
I also transcribe for ENT docs in my area, before I went on maternity leave I asked them to use my digital phone in system (really didn't expect them to since they were 'set in their ways' but they agreed).
As far as getting new clients, I would get some business cards printed out, and some fliers stating what equipment you will use, i.e. tapes, digital; will you be dropping the finished work off, and also turn-around-time. Then if it were me, I would take these to local doctors, speak with the office manager and offer your services, may be you can start off by offering to cover vacations (I know how hard it is to get coverage for yourself on vacation. You might have to start small and work your way up, but at least it is a start.
Well that is all I can think of, I hope this is helpful to you. Good luck!!
Best way to get clients? sm
I want to market my service in my area. I have gone to offices before in the past, but they sometimes get annoyed. I have also done mailings and get no response. Is there another way to get the OM's attention that maybe I overlooked? Any suggestions would be appreciated.
Some clients won't go there
Some doctors have such rotten dictating habits they know running their reports through ASR will result in utter garbage; they have TAT to meet and they know if they take the time to have those reports extensively edited post ASR its just an extra step. Some clients know for them it will be a time and money waster; it is the MTSOs that are pushing for all ASR, not the clients. Many hospitals have tried ASR inhouse and end up scrapping it and going back to MTs. Its a lot like outsourcing in that many people are on the bandwagon, but there'll always be some that refuse to ride it.
Clients have the right to not have an
MT transcribing that reports if that MT continually makes mistakes. Not talking about the ones QA catches, but the reports that are sent straight through without QA and they catch the mistakes on their end and have to send it back. The client I am assigned at my MTSO has said that certain mistakes will not be tolerated and those that make those will not work on their account. They have the right to pull the account from the MTSO if their wishes are not followed by the MTSO.
getting own clients
Does anyone have a sample letter that I can look at to try to get my own accounts? I would really appreciate the help if there is anyone willing. I just need something to get an idea of what to cover in a letter just to get my foot in the door.
Thanks in advance.
I don't have any of my own clients...sm
so I have never had this problem. They said you were no longer transcribing his letters. Does that mean you are still transcribing other types of reports for him or is that the only type of report you did for him?
If the secretary called you before and asked questions about "How often ARE you coming to get work" or something to that effect, then it leads me to believe he was not happy with you for some reason. Sounds like he found someone else to do his work. He could have found someone to do it cheaper, who knows? I hate to hear you lost this client. I know money is tight.
Why not just get your own clients?
Just curious why you would rather subcontract when you could just get your own clients and make more money instead of paying a middle man.
I just heard clients are now
very interesting, indeed.
Finding Clients
I had gotten my previous clients when I worked in a hospital Medical Records Department as an MT. The docs just came to me and asked me to do their work at home. I am going to have a professional letter and business cards made up now to send to local doctors, just anyone in the phone book who looks good, but mostly cardiology, neurology, neurosurgery and orthopedic docs. They seem to have the most consultation letters.
Contracting own clients
It's actually two units attached and working together: A Sony BM-890 microcassette dictator/transcriber and a DTI-800 phone interface. I bought the unit (years ago) for about $1,300.00. The top unit (BM-890) is where you put the tapes in and is like a regular Sony transcriber. (I transcribed the tapes on a separate transcriber, though). The unit gives the doctors the option of pausing and backing up to listen to their dictation and make changes if needed.
Contracting own clients
I agree - to make good money, you need to get your own accounts. My long-time cardiology group account just got EMR with VR, however, so I need to find a new account now. This one was really nice in that the doctors dictated over their phones to my Sony answering system, and then I would just e-mail the completed work back at the end of the day for the office to print it all out there; I never had to do any pickups of tapes or delivery of hard copies. Just wondering now, is this very unusual, or do others here have similar arrangements? Thanks.
None of my clients have no idea what a CMT is...
Seems like they should spend more time/money educating doctors about the mere existence of CMTs instead of rolling out another level of certification.
Ditto! What do clients think when they -
It appears as though the majority of this company's managers don't even know how to type! Must look awful if they use emails to communicate with clients!
I would just tell your clients that you have expanded, now
having 2 branch offices and that all invoices are being generated out of your new office and that is where payments should be made.
One of my clients uses Chartscript
It is a little confusing at first, but once used to it, it is a breeze. You just have to be careful because the system is picky about what it will accept, such as no % signs, but rather spelled out, etc. Not hard. If I can do it, anybody can. :^)
It COULD be a lot worse. And clients and QA are much more likely
to comment on obvious padding than grammar errors, so I'd keep my head down if I were you. Just do it the right way. You say there is no QA, but if you get yearly reviews or anything, do mention you would appreciate any feedback on quality that they were able to provide. But I'd rather work with somebody who is padding their reports a bit than somebody whose work is full of grammar errors or real medical errors like I've seen so much of in the hospitals where I have worked.
For people who have their own clients....
Do you bill monthly, twice monthly, or bi-weekly? I have work from a hospital coming soon and wondered how most people bill. Also, while I'm in the process of making up a contract, what would you say is the norm in terms of the percentage you would charge if they were late in paying you? About how long after you send the bill do you expect to be paid? I know all of these things are negotiable, I would just like some feedback on what others are doing as this will be my first contract.
Thanks a lot!
"stealing" clients
Actually I DO believe what you did here was unethical. And it is the exact reason that noncompete clauses get created. Any MT who is contracting with a service has no business going straight to a client UNLESS they have been asked to do so by the service they work with. To do so and then make an attempt, successful or not, to take that client away from the service does smack of ethics that I wouldn't want to be associated with personally.
These are not local clients.
They are nationwide clients. I provide digital dictation access.
I also have QA contractors that are included in my overhead costs as much as the MTs.
It's always been my experience, with your own clients...sm
you can produce many more lines per hour (as you become so accustomed to them, you know what they'll see before they even do). On the other hand, when I have worked for nationals, my production is way lower because I have always been tossed around to different specialties. Those account specifics for each specialty (worked for hospitals through nationals, combined with the templates, looking up referring physicians, etc. will your eat your productivity up. You have to weigh the pros and cons of having your own clients or working for a company. My wrists, hands, and neck are starting to wear down after over 20 years of this. I certainly don't miss the overhead costs of having my own clients, estimated taxes, etc. I used to be able to whip out 2,000 lines a day easily with my own clients, now I do 1,000 per day with a company, and I am quite content with that because I can no longer stand being strapped to a computer for hours and hours. I think my kids (now grown), thought the desk and computer were a permanent body part of mine!
ah, but just because your clients don't follow BOS,
nm
Questions about getting clients. sm
I want to get a client and was hoping to get some suggestions on what has worked best for others.
I was wondering how I should dress when going to an office to give out flyers. I was wondering if flyers were a waste of time. Any suggestions to help get my services noticed would be appreciated.
private clients
It is refreshing to see normal expected amounts given to other MT. So often I see "I would not expect less than 10.00 per page and such high line counts" I believe the misconception by many is that you can make a bundle with little effort given some of the "I won't do this" attitudes. When looking for your own private accounts, think about who they are, where they are coming form and who did them before and assess accordingly. And keep in mind you may have to negotiate and get a bit less but your first client and everyone after is your own - which is a good thing
You get your own clients, then you hire them...sm
MTSOs are paid on production, too, so most simply cannot take on the task of training a newbie. If you think that's a good business plan, get some clients and give it a whirl. It's just not realistic to expect MTSOs to train inexperienced MTs and still have enough hours in the day to handle other aspects of the business, as well - and still make a small profit of some sort.
When I see suggestions like this, I have to assume they come from someone who has never even run a business before. It's easy to sit on the sidelines and make suggestions when you have no idea what is involved. The MTSO doesn't just sit on his/her tush and eat bon-bons while the MTs type their fingers to the bone. There is a LOT that goes into running a successful service (key word successful). The lucky MTSOs find enough help to where they don't have to transcribe and can handle just the business aspect, but many aren't that fortunate and still do a good deal of transcribing along with that.
Besides training those inexperienced MTs - and that's a full-time job in itself, believe me - you will have to proof their work very thoroughly (which will mean a full listen on all sound files to ensure accuracy or risk losing your clients altogether). You will also be responsible for tracking and assigning work to the MTs, scurrying to find help when someone decides they'd rather go shopping than work that day (happens more often than you might think), handle payroll and tax documentation for each individual client and each individual MT, invoicing and billing your clients and tracking payments, maintenance of equipment and supplies, handling client phone calls and concerns including next-to-impossible "tech support" questions from clients that really just don't understand the equipment, etc., etc. The list goes on.
Keep in mind, while you are training the inexperienced MTs, you will also need to do a LOT of transcription yourself. Most inexperienced MTs will take all day to finish one 25-minute file, so you will have to transcribe many lines yourself to meet the client's TAT if you want to keep the clients. Since it takes most people at least a year to finish MT school, you can count on keeping up this pace for about that long. And it would probably be more like indefinitely since everyone learns at a different pace.
You will be putting in at least 12-hour days, assuming you are fast and efficient, and you will rarely get time off. If you do take time off, it will be without pay and when you return, you will have so much work piled up that you'll spend the next 2 weeks working around the clock to get caught up.
I'm all for keeping it in the USA, but you cannot seriously expect companies that are also paid on production to train newbies. Would you expect to be trained from the bottom up to be a plumber? Doctor? Dentist? Lawyer? Why do so many MTs think they deserve to be hired without any skills?
If you are up to training inexperienced MTs on top of all that, knowing full well that you will make next to nothing in pay yourself after you pay said MTs at least 7-8 cpl, then knock yourself out and be sure to let us know how it goes!
If I wanted to train inexperienced MTs, I'd start an MT school. Yes, we were all new and inexperienced at some point, but since MT has gone to production pay and offsite, most are not trained OTJ anymore. It's just not feasible, no matter how good your intentions. Even the "experienced" MTs require some training on account specs, so most MTSOs lose money in the first month or so of hiring, but there's no way any smart businessperson would agree to that indefinitely.
If you want to keep jobs in the USA, get adequate training and act professional. Don't accept rotten line rates, even if it's just "for now," and don't turn in work with careless mistakes. Don't say you'll work but then call off because you'd rather take Little Mary and Johnny swimming because it's a nice day. Don't expect special treatment just because you're a mom - many MTSOs are moms, too, and are working long hours and sacrificing time with their own families in order to make sure the clients are happy!! There is no option for MTSOs to just blow work off for the day, because if they do, they probably won't have clients come the next day. Clients won't put up with it since they can just get online and find another service willing to do the work (and more often than not, they don't even have to do that becuase services are marketing to them regularly).
It's not even about offshore competition. It's about changing the way MTs are viewed on the whole. Act professional and you will be treated as a professional. It really is that simple the majority of the time.
And I might add, wondering where all those clients would go
and if the MQ has a heads up to those clients. What about patient care? We all are thinking of ourselves that that platform is down. What about the patients who are not getting their H&Ps and STATS into the chart? Man, if I owned an MTSO, I'd be calling all over the place to see if anyone needs a new supplier for good transcription. Just IMHO.
That's way too low for IC with direct clients. sm
I live in a small midwestern town, so believe me, line rates aren't splendid here but as an IC, you should charge at least 10 cents per line. However, you should add up your expenses, i.e., supplies you'll need, gas if deliveries, etc., and figure out what you need in order to turn a profit on top of that. If a practice won't pay 10 cents per line, you don't want it because they're just looking for a bargain and the first person that walks in quoting a cheaper rate will have your job. JMHO as someone who has dealt with direct clients for almost 10 years now.
It seems like a lot, but I have demanding clients
who don't telecommute, so I have to drive 44 MI each day to pick up and drop off. I have to print the original note and any copies, print envelopes. If they call and need something ASAP, I am expected to drop everything and type and fax it to them. If I am out sick or on vacation, I am not permitted to subcontract it out to another MT. It sits until I get back and then I am expected to work extra hours to make up the work. There are only a couple of MT's, who work from home, and we are supposd to complete dictation for 9 Drs/NP's in 24 hr turnaround. Also, I am supposed to abbreviate as much as possible to cut down costs.
I'm not giving my clients away, plus
up tapes twice a week; neither one of them will go digital. You would like the pay on one though; they pay me for blank lines, which is great. I do wish you luck on your search. I didn't say they were "pain in the butts," but just simply stating that 8 cpl not to have to deal with the administrative end can be worth it sometimes. I'm on the East Coast.
I charge my clients
anywhere between 18 cpl and 28 cpl depending on work type, TAT, and other factors. I have a couple of clients who are rather high maintenance and they are charged accordingly.
I'm gonna say what the clients say - oh, boy, ANOTHER one, ick. NM
.
No local clients to be had here
I figured contracting with a larger National would establish my business.
Transcend is taking on new clients
But they are also experiencing a high rate of turnover due to their new platform that has a lot of problems and a lot of downtime. It seems like they're always adding new clients, but the work load has been chronically low for months. Manager said that they have had to overstaff in anticipation of the new accounts, but with getting new accounts often, they have to overstaff often. Even with the turnover because of the new not-so-user-friendly platform and voice recognition the work is still low and the turnover just keeps increasing because new ones can't afford to wait 3, 4, or sometimes 5 pay periods for it to pick up, and a lot with seniority are getting sick of it and moving on. It will all even out eventually, but who can afford to wait these days, especially when paid at 55% of regular rate for voice recognition. It don't matter how fast you can edit if there isn't any work and you're only getting 55% of your pay. Their suggestion: Take some time off or work shifts that may not be so convenient for you or your family (that's what everyone is doing anyway - so there still is no work). When my mortgage and car payment is due, I'll be sure to tell the bank that my employer told me to take some time off so I can't pay it this month. Think they'll be as understanding as Transcend expects us to be?
I think OP meant one IC job with multiple clients...
If you are working as an IC at more than one place, you only have one job as an IC but you have more than one client. Tis true.
I seems strange that clients would be jumping
ship when the TAT time is pretty much up to the minute. You would think transcriptionists would be jumping ship instead. I don't believe the clients are jumping ship.
and they have offshore services as clients.
t
Making 0.12 per line with my own clients. (nm)
x
Telephone dictation for your clients
Anyone interested in offering toll free dial in dictation to their clients? I found a small company that is offering this service for $45/mo. It seems very reliable and they deliver my dictation files via FTP as a .wav file.
If interested reply back and I'll send you their contact info.
It depends on what your clients or account wants. sm
BOS sometimes does not matter. The only thing that matters is what the people who sign your paycheck want on their reports.
There would never be a valid reason to go to her clients - ever. sm
Remember - those clients are her bread and butter. HER business is to protect HER BUSINESS. Late TAT one time would not be enough reason to stop using your services. Late TAT enough times that SHE is getting uncomfortable with the client is ample reason.
You have no business relationship with the clients. Your business relationship was with the MTSO.
New clients with no computer knowledge
I just landed a new awesome client because they were desperate. They didnt even have internet! I talked them into go with a DSL line, I bought them a digital recorder (with USB connector)..I had my computer guy write a script. all they have to do is plug the recorder into the USB connector, press a button on the desk top (that has script written by my computer geek) and it automatically sends it to me...the files are sent back, they press another scripted icon on their desk and VOILA they have the work back. They have no idea what they are doing either....but they are learning slowly and I have a great new account (all mammograms and ultrasounds 2 days a week)
I LOVE IT!
I use the enclosed for my meetings with new clients. May be able to use some of them--sm
Spec Sheet
„Ï How many doctors? ________. Names and credentials exactly as wanted for signature line.
„Ï Clinic hours_______________________
„Ï Does office close for doctor¡¦s vacation?
„Ï What is the estimated amount of dictation in minutes per day?
„Ï Turnaround time__________
„Ï Is there ever any STAT work needed? If so, what are the expectations for that work?
„Ï
„Ï Pickup time___ if tape is not ready at this time, TAT is no longer in effect.
DICTATION
„Ï Micro cassette___________ C-phone______________
„Ï Return cassette unerased?
„Ï Will patient log sheet be provided for name spelling/acct #?
„Ï Will office sign for returned work? _________ POC ___________
„Ï What font?
„Ï How do they want you to flag blanks or questions? How to flag for any questions/inconsistencies
„Ï
„Ï Samples provided?
PRINTING
„Ï How is transcribed data to be returned? Printed_______Floppy disk ____
„Ï If printed, client____ service _____will provide paper, letterhead, envelopes.
„Ï If I have to call the office to determine proper spelling of patient's names or doctors¡¦ names the turnaround time is no longer guaranteed.
„Ï Typing letters and envelopes or just actual medical reports. If addresses are not provided for recipients of letters, there will be an added clerical service fee for my time of $0.25 per letter/envelope.
„Ï
„Ï Faxing or mailing reports to third parties will not be done.
BILLING INFO
„Ï What kind of invoice is preferred?
„Ï Billing date: ___________ Payment date: _____________
„Ï Reprints for transcribed data delivered in the past and signed for by office staff will be charged at $0.75 per page.
„Ï _________________________________________________
„Ï Reprints¡Xreprints of reports with an error made by me will be provided at no charge. Reprints of reports with corrected errors by the doctor will be provided at $0.75 per page.
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